DS-DE 9
STATE OF FLORIDA
APPOINTMENT OF CAMPAIGN TREASURER
AND DESIGNATION OF CAMPAIGN
DEPOSITORY FOR CANDIDATES
(Section 106.021(1), F.S.)'
.QFFIC ~
lUOI JAN 2 . -. D
CITy CL ,,2 PH~: 43
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OffICE
(PLEASE TYPE)
CHECK APPROPRIATE BOX:
o Original Appointment
Name of Candidate
D Deputy Treasurer
D Reappointment of Treasurer D Secondary Depository
1. Address (include post office box or street, city, state, zip code)
Telephone (optional)
c.. L
2. Party (Partisan candidates only)
(/~I E. ~ ,() . />18.
3. Office (add district, circuit, group number)
c
o Campaign Treasurer
I ha~e appointed the following person to act as my
4. Name of Treasurer or Deputy Treasurer
o
5. Mailing Address (If post office box or drawer add street address)
7. City
8. County
9. State
6. Telephone
-SI1 e
10, Zip Code
...73 ':!
D Primary Depository D Secondary Depository
12. Street Address
I have designated the following named bank as my
11. Name of Bank
W /I"J
13. City
17. ~nature of Candidate
16. Zip Code
.33 '.3
t.-
14. County
Date
/ - ~
I,
Campaign Treasurer's Acceptance of Appointment
LiMPI1 brt1..fZ-.
(Please Print or Type)
, do hereby accept the appointment as
Q'Campaign Treasurer D Deputy Treasurer for the campaign of
LII1/D/J
0r-1l.J'z-
who is seeking nomination or election as a
candidate to the office of
/11/ /f
(f1arty)
C.(! PJ"1 i....f,.( "to,!}!!, J'l" '-rr . As a duly registered voter in
County, Florida, I am qualified to accept this appointment.
f:}!I 0 t5
UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING CAMPAIGN TREASURER'S
ACCEPTANCE OF APPOINTMENT AND THAT THE FACTS STATED ARE TRUE.
(- ~ 2 - en
Date
x
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Signature 0 Camp Ign Treasurer or Deputy Treasurer
DS-DE 9 (Rev. 02/06)